Amsterdam. October 19 th, 2018. Research finds that the country’s strict abortion laws have negative consequences for women’s well-being and there there is no significant decrease of women looking for access to online abortion pills through Women on web, even though women from Northern Ireland can now obtain free abortion services in Great Britain, suggesting a public-health rationale to decriminalize abortion.

Despite a policy change to provide free abortion services for women traveling from Northern Ireland to clinics in Great Britain, Northern Irish women still experience multiple barriers accessing care, according to new research by Abigal Aiken from the LBJ School of Public Affairs at The University of Texas at Austin. The study also found that some women preferred to use medication from online telemedicine services to self-manage their own abortions at home, but that the experience is dominated by fear and isolation due to the risk of prosecution.

Northern Ireland’s abortion laws permit the procedure only to preserve a woman’s life or prevent permanent long-term physical or mental injury. Any abortion taking place outside the law is punishable by up to life in prison.

Abigail Aiken, an assistant professor of public affairs and a fellow of the Richter Chair in Global Health Policy at the LBJ School, conducted anonymous in-depth interviews with 30 women living in Northern Ireland who either traveled to England to obtain an abortion in a clinic or who self-managed a medication abortion at home using online telemedicine. Results show barriers to traveling for abortion services, including the cost of travel, the inability to receive care confidentially and the challenges of arranging child care or taking time away from work.

“The recent policy change to provide free abortions for women traveling from Northern Ireland to clinics in Great Britain has not been sufficient to create a reliable and accessible pathway to care,” Aiken said. “In addition to the physical toll and emotional stress of traveling overseas, many women do not have the required travel documents or need to keep their abortions secret from their families or communities.”

Women in the study often said they found self-managing their abortions at home with medication more acceptable than travel. In the paper are the following key findings:

1. Despite a new policy enacted in July 2017 to provide women traveling from Northern Ireland with free abortions in England, Northern Irish women still experience multiple barriers to travelling to access care. The number of women who received abortion medications from Women on Web in the year after the policy change decreased by only 3% compared to the year before the policy change.

2. Self-managed medication abortion using online telemedicine may be preferred over travel due its convenience and safety, but the experience is dominated by fear and isolation due to the risk of prosecution.

3. The documented obstruction of abortion medications by Northern Ireland Customs officials engenders fear and anxiety among women who are waiting for their shipment. Many fear that their package will be delayed or will never arrive. Some women try less effective methods (such as high doses of vitamin C or parsley pessaries) or unsafe methods (such as drinking large amounts of alcohol or engaging in physical harm) while waiting for their abortion medication.

4. Lack of clarity surrounding Northern Irish abortion laws delays access to care and fuels mistrust of the healthcare system. Women avoid interacting with healthcare professionals before and after their abortions for fear of being reported to the authorities.

Earlier this year, an overwhelming majority in Ireland voted to repeal the Eighth Amendment outlawing abortion, and legislators in the Isle of Man also voted to legalize the procedure — moves that put pressure on lawmakers in Northern Ireland and the UK Parliament to re-examine the country’s abortion laws. In a 2017 survey, nearly 80 percent of Northern Ireland’s population supported changing current regulations.

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